MDC III Final Exam/MDC 3 Final Exam
respiratory alkalosis
high pH, low CO2
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
metabolic acidosis
low pH, low HCO3
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
respiratory acidosis
low pH, high CO2
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
metabolic alkalosis
high pH, high HCO3
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
▪ change in condition make take priority over ABCs (ex: post op bleeding is priority over an O2 Sat% of
90%)
▪ pick the patient that is going to die first
Priority questions...something to consider
CPR, press the code button
You walk into your patient's room and they don't have a pulse, what are you going to do?
bag resuscitation, press the code button
You walk into your patient's room and they are not breathing but have a pulse, what are you going to
do?
, ▪ unconscious, pulseless
▪ shock them with the AED!
If you walk into a room with a patient that is in ventricular fibrillation (v fib)
▪ How will they present?
▪ What must we do to get them out of that state?
▪ make them bear down (valsalva maneuver)
▪ make them cough (vagal maneuver)
If you walk into a room and a patient is alert and oriented, speaking to you, has a pulse, but their cardiac
monitor shows they are in ventricular tachycardia
▪ What are you going to do?
Supraventricular Tachycardia (SVT)
Which cardiac rhythm requires the patient to take adenosine?
▪ they may end up with a blood clot because the blood is pooling in the atria
What is our priority concern for a patient in atrial fibrillation (a-fib)?
control RVR for patient:
▪ give anticoagulants
▪ beta blockers, digoxin, diltiazem
▪ if meds don't work...cardioversion (synchronized shock to re-start the rhythm)
▪ if cardioversion doesn't work...ablation
Nursing Interventions: A-fib RVR
▪ chest pain
▪ SOB
▪ diaphoresis
▪ N/V
▪ hypertension
▪ tachycardia
▪ jaw pain, anxiety, indigestion (women)
▪ elevated troponin levels
▪ EKG changes - ST elevation
If you have a patient who comes into the ED and they are having an MI, what are the signs/symptoms?
lab values to confirm this?
SATA?
Oxygen - 1st
Nitro - given sublingual, 3 doses q 5 min (home), drip (hospital), drops BP (vasodilator)
respiratory alkalosis
high pH, low CO2
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
metabolic acidosis
low pH, low HCO3
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
respiratory acidosis
low pH, high CO2
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
metabolic alkalosis
high pH, high HCO3
pH: 7.35-7.45 acidic-basic
HCO3: 21-28 acidic-basic
CO2: 45-35 acidic-basic
▪ change in condition make take priority over ABCs (ex: post op bleeding is priority over an O2 Sat% of
90%)
▪ pick the patient that is going to die first
Priority questions...something to consider
CPR, press the code button
You walk into your patient's room and they don't have a pulse, what are you going to do?
bag resuscitation, press the code button
You walk into your patient's room and they are not breathing but have a pulse, what are you going to
do?
, ▪ unconscious, pulseless
▪ shock them with the AED!
If you walk into a room with a patient that is in ventricular fibrillation (v fib)
▪ How will they present?
▪ What must we do to get them out of that state?
▪ make them bear down (valsalva maneuver)
▪ make them cough (vagal maneuver)
If you walk into a room and a patient is alert and oriented, speaking to you, has a pulse, but their cardiac
monitor shows they are in ventricular tachycardia
▪ What are you going to do?
Supraventricular Tachycardia (SVT)
Which cardiac rhythm requires the patient to take adenosine?
▪ they may end up with a blood clot because the blood is pooling in the atria
What is our priority concern for a patient in atrial fibrillation (a-fib)?
control RVR for patient:
▪ give anticoagulants
▪ beta blockers, digoxin, diltiazem
▪ if meds don't work...cardioversion (synchronized shock to re-start the rhythm)
▪ if cardioversion doesn't work...ablation
Nursing Interventions: A-fib RVR
▪ chest pain
▪ SOB
▪ diaphoresis
▪ N/V
▪ hypertension
▪ tachycardia
▪ jaw pain, anxiety, indigestion (women)
▪ elevated troponin levels
▪ EKG changes - ST elevation
If you have a patient who comes into the ED and they are having an MI, what are the signs/symptoms?
lab values to confirm this?
SATA?
Oxygen - 1st
Nitro - given sublingual, 3 doses q 5 min (home), drip (hospital), drops BP (vasodilator)
